…pattern Pattern Predominant Consider : : : Hepatocellular ALT and AST ↑↑, ALP normal Viral hepatitis, drugs, alcohol, autoimmune hepatitis, ischaemic hepatitis, steatohepatitis Cholestatic ALP and GGT ↑↑…

…with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal…

…Ischemic cardiomyopathy Alcoholic cardiomyopathy Diabetic cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart disease Long term prognosis…

Cardiology Clinical medicine Definition and scope Alcohol has dose , pattern , duration , sex , and genetically influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic…

…8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in…

…blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with the needle stings. Needles of…

…or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of joint infection (relative; aspiration can seed a sterile joint)…

…asthma attacks, angioedema, or urticaria with NSAIDs). Alcohol consumption may increase the risk of gastrointestinal bleeding. Serious skin reactions (e.g., Stevens Johnson syndrome, toxic…

…age 65, and concomitant drug/alcohol use. Some studies suggest HAS BLED has comparable or slightly superior predictive capability for major bleeding compared to ATRIA…

…of tricyclic antidepressants reduces the effect of clonidine. • Clonidine increases the CNS depressive effects of alcohol and sedatives. Clonidine doses and administration in hypertension (hypertensive…

…leeding history or predisposition L abile INR (International Normalized Ratio) E lderly (age 65 years) D rugs/alcohol concomitantly Each component is assigned 1 point…

…Recognised causes include: Diabetes and insulin resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy…

…myocarditis, sarcoidosis, rheumatic heart disease, connective tissue disease, eosinophilic myocarditis), toxins (alcohol, cocaine, cancer therapies), or physical reactions (radiation therapy), frequently involves the conduction system…

Cardiology Clinical medicine Definition and Scope Primary prevention aims to prevent the clinical manifestation of cardiovascular disease (CVD) in individuals without established clinical CVD. It…

…INR), older age, drugs predisposing to bleeding and alcohol use. A high bleeding risk score should prompt correction of modifiable risk factors and closer surveillance…

…AVRT (pre excitation, WPW syndrome) being the most common. Atrial fibrillation with onset during hyperthyroidism (thyrotoxicosis), alcohol overdose, thoracic surgery, acute myocardial infarction, pericarditis/myocarditis…

…anemia, myocardial ischemia/infarction, pulmonary embolism, pheochromocytoma, hyperthyroidism, hypovolemia, pharmacological substances (alcohol, amphetamine, coffee, anticholinergic drugs, beta adrenergic agonists). In all of these conditions, sinus…

…present, neurological examination, gait and truncal stability Acute balance syndrome Acute persistent unsteadiness or ataxia without clear spontaneous nystagmus Cerebellar or brainstem infarction, intoxication, Wernicke…

…easy to trust too much. Two errors make the reading useless without anyone noticing: the transducer is at the wrong height , and the system is…

…fields. Preparation and equipment Informed consent, current full blood count and coagulation screen, medication list. Chlorhexidine in alcohol, sterile gloves, fenestrated drape, sterile gauze. Local…

…the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a vessel that turns…

…The condition occurs above all in: treatment with SGLT2 inhibitors pregnancy prolonged fasting or a very low carbohydrate intake excessive alcohol consumption vomiting or othe

…preparations. Contraindications Measure Contraindication : : Medicinal charcoal A reduced level of consciousness without a protected airway — a risk of aspiration Medicinal charcoal A corrosive substance (acid…

…history of gastrointestinal bleeding Refeeding syndrome There is a risk in starvation, alcoholism, anorexia nervosa, or more than 5 days without nutrition. Check the phosphate…

…Informed consent, coagulation status and an up to date medication list. A sterile fenestrated drape, chlorhexidine in alcohol, sterile gloves, a face mask. An atraumatic…

…Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block (adrenaline is safe in fingers and…

…commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often lacks abdominal…

…and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests a raised filling pressure Marked respiratory variation in…

…reaches the patient. Preparation and equipment Cannulae in several sizes, a tourniquet, chlorhexidine in alcohol 5 mg/mL, gauze, a transparent dressing, an extension set…

…cap, mask, fenestrated drape. Chlorhexidine in alcohol 5 mg/mL. Local anaesthesia: lidocaine 10 mg/mL, 10–20 mL, a 25 G needle for the…

…time, and whether the intake was single or repeated a modified release preparation or a combination product concurrent drugs, alcohol and illicit substances weight, age…

…cutaneous vasculitis, lymphoma or granulomatous disease. A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma…

…acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL. Needles: 21–25 G…

…through a 20 mL syringe and a large bore needle. Chlorhexidine in alcohol to the skin around the wound — not into the wound. Sterile gloves…

…Labile INRs, Elderly age ( 65), and Drugs/alcohol. A crucial clinical pitfall is the misapplication of this score. A high HAS BLED score (≥3) indicates…

…conditions listed above. It is important that history taking and physical examination is carried out systematically and carefully without delaying time to treatment. History taking…

…ingestion unless the ingested substance has the propensity to form bezoars or is a sustained release formulation. Note: activated charcoal is ineffective against alcohols, lithium…

…hanging or strangulation. Drug overdose Intentional or accidental overdose of medications, drugs or other substances (including alcohol) causing cardiac arrest. Table 1. Classification of causes…

…also referred to as primary hypertension . Essential hypertension is defined as hypertension without an identifiable underlying cause. Researchers previously believed that this form of hypertension…